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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Melasma Medication Dependency Be Suspended?

Hi I have suffered from melasma now for several years I changed from the combined pill to the progesterone only pill which hasn't appeared to make any difference. I am going on holiday in 10 weeks and I'm seriously considering coming off the pill completely. Is this likely to stop my melasma?
Sat, 17 May 2014
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General & Family Physician 's  Response
Thank you for asking!
Treatment of melasma is not easy and fast. It comes slowlya nd goes slowly. All wavelengths of sunlight, including the visible spectrum, are capable of inducing melasma. The best treatment remains a topical hydroquinine cream, sun avoidance, and no estrogen exposure. Boosters are only of limited benefit.Quick fixes with destructive modalities (eg, cryotherapy, medium-depth chemical peels, lasers) yield unpredictable results and are associated with a number of potential adverse effects, including epidermal necrosis, postinflammatory hyperpigmentation, and hypertrophic scars.Regardless of the treatments used, all will fail if sunlight is not strictly avoided. Prudent measures to avoid sun exposure include hats and other forms of shade combined with the application of a broad-spectrum sunscreen at least daily. Sunscreens containing physical blockers, such as titanium dioxide and zinc oxide, are preferred over chemical blockers because of their broader protection. UV-B, UV-A, and visible light are all capable of stimulating melanogenesis. In addition, you are and should be forewarned that resolution is gradual and may take many months so hang in there.
Discuss depigmentation agents, retinoids and antibiotics with your dermatologist.
Take care
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Can Melasma Medication Dependency Be Suspended?

Thank you for asking! Treatment of melasma is not easy and fast. It comes slowlya nd goes slowly. All wavelengths of sunlight, including the visible spectrum, are capable of inducing melasma. The best treatment remains a topical hydroquinine cream, sun avoidance, and no estrogen exposure. Boosters are only of limited benefit.Quick fixes with destructive modalities (eg, cryotherapy, medium-depth chemical peels, lasers) yield unpredictable results and are associated with a number of potential adverse effects, including epidermal necrosis, postinflammatory hyperpigmentation, and hypertrophic scars.Regardless of the treatments used, all will fail if sunlight is not strictly avoided. Prudent measures to avoid sun exposure include hats and other forms of shade combined with the application of a broad-spectrum sunscreen at least daily. Sunscreens containing physical blockers, such as titanium dioxide and zinc oxide, are preferred over chemical blockers because of their broader protection. UV-B, UV-A, and visible light are all capable of stimulating melanogenesis. In addition, you are and should be forewarned that resolution is gradual and may take many months so hang in there. Discuss depigmentation agents, retinoids and antibiotics with your dermatologist. Take care